Senior Special Investigations Unit Medical Reviewer Job at Vantage Consulting, Rancho Cucamonga, CA

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  • Vantage Consulting
  • Rancho Cucamonga, CA

Job Description

Join a team dedicated to "healing and inspiring the human spirit" as a Senior Special Investigations Unit Medical Reviewer. In this role, you will:

  • Conduct clinical reviews of medical records and claims to identify coding errors and potential healthcare fraud.
  • Provide mentorship to SIU Medical Reviewers.
  • Support quality initiatives aligned with HEDIS, CAHPS, and NCQA Accreditation.

Qualifications include:

  • 5+ years of medical review experience in a healthcare SIU.
  • Bachelor's degree in a related field or equivalent experience.
  • Certification as a CPC, CPMA, or CCS.
  • Active LVN or RN license in California.

Enjoy competitive benefits, career advancement, and a supportive work environment. Apply today!

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